POSITION SUMMARY:

Responsible for billing of all guarantors. Reviewing and verifying client ledgers, reports, and eligibility. Processing changes in information system to support accurate and efficient billing. Following up on unpaid claims and MHC guarantors. Update monthly guarantor financial eligibility. Other duties as assigned.

QUALIFICATIONS:

High school diploma is required. One year of experience in a healthcare facility, medical office or FQHC billing. Proficient accurate data entry , as well as intermediate to advanced computer proficiency is required. Working knowledge of ICD-10 and CPT/HCPCS coding standards. Capable of pertain a 10-key calculator.

PHYSICAL DEMANDS:

Abilities in reaching, bending, talking, fingering, sitting, carrying, standing, grasping, fine hand coordination, ability to hear, ability to read and write, and the ability to remain calm under stress. Ability to reach with hands and arms, climb stairs, balance, stoop, kneel, crouch or crawl. Specific vision abilities include close, distance, color, peripheral, depth perception and the ability to adjust focus. Must be capable of lifting 50 pounds of dead weight alone. May be required to complete standing presentations involving speaking and listening to audience.

WORK ENVIRONMENT:

General office, health care setting. Most work completed while seated at desk using standard office equipment. Fast paced, team approach. Multi-tasking requiring above average time management skills. Team approach.

FUNCTIONAL RESPONSIBILITIES INCLUDE:

• Billing all third party payers bi-weekly and self-pay monthly.
• Verifies completeness and accuracy of all claims prior to submission.
• Regularly meet with Account Manger to discuss and resolve reimbursement issues or obstacles.
• Reviewing financial edibility monthly for Gracepoint clients and updating the guarantors and notifying changes to the Program Manager and Managed Care if authorization is required.
• Retains accurate file maintenance of EOB's from payers and refunds
• Timely follow up on insurance claim denials, exceptions or exclusions.
• Performs other patient accounts receivable control and review functions

COMPLIANCE RESPONSIBILITIES INCLUDE:

• Adheres to all applicable federal, state, local, and company maintained standards of compliance, ethics, and policies concerned with the administration and delivery of agency services.
• Meets deadlines, requirements, and expectations as established by the supervisor, agency and department.
• Completes administrative functions and data entry timely and accurately.

CUSTOMER SERVICE RESPONSIBILITIES INCLUDE:

• Provides exceptional customer service in all communications and interactions with staff, general public.
• Maintains confidentiality and remains calm under stress.
• Assists staff with support in all areas of functional responsibility in a courteous, supportive manner.
• Maintains and exhibits servant leadership qualities and exceeds customers' expectations.

FISCAL RESPONSIBILITIES INCLUDE:

• Effective, efficient use of agency resources, systems, equipment and processes.
• Continuous focus on cost savings initiatives across the responsibilities and deliverables.
• Effective use of time management to avoid overtime and budgetary issues.